# Characterization of central pain mechanisms using simultaneous spinal cord-brain functional imaging

> **NIH NIH R01** · STANFORD UNIVERSITY · 2020 · $590,576

## Abstract

Significance: Chronic pain affects approximately 100 million Americans, costs our society half a trillion dollars
per year, and is challenging to treat effectively. Functional magnetic resonance imaging (fMRI) of the brain -
and more recently the spinal cord - have advanced our knowledge of the central nervous system (CNS)
correlates of pain processing in humans. Additionally, brain fMRI is demonstrating much promise as a potential
pain biomarker. Convention has been to perform brain/brainstem and, only more recently, spinal cord imaging
separately. But a link between the human brain and spinal cord remains conspicuously missing. To fully
characterize abnormal CNS mechanisms of chronic pain and pain modulation, we need to understand the
intricate interplay between these structures.
Preliminary Data: We have demonstrated successful simultaneous spinal cord-brainstem-brain fMRI by
overcoming the magnetic field shimming obstacles. We have also demonstrated the ability to image the CNS
correlates of pain and pain modulation. We propose to use this innovative technology of simultaneous spinal
cord-brain fMRI to more fully characterize CNS mechanisms of chronic pain and pain modulation, and also to
develop improved corticospinal biomarkers of the chronic pain condition fibromyalgia (FM).
Specific Aims: In Aim 1, we will enhance our innovative simultaneous spinal cord-brain imaging sequence to
minimize the impact of cardiovascular-induced spinal cord motion. We will contrast the optimized sequence
against our currently working sequence while characterizing the CNS mechanisms of thermal pain intensity
encoding. In Aim 2, we will characterize central sensitization (using pressure pain, temporal summation (TS) of
pain, and resting state functional connectivity) and in Aim 3, descending modulation of pain (using conditioned
pain modulation (CPM) and emotion reappraisal (ER)). Our preliminary data demonstrates feasibility and early
insights into these mechanisms. Finally, in Aim 4, we will use the complete CNS imaging of pain and its
modulation within our established multivariate pattern analysis (MVPA) models to better inform mechanistic
knowledge and classification procedures.
Overall Impact: Successful completion of our aims will advance scientific knowledge of the complex interplay
between the spinal cord and brain in chronic pain and pain modulation. Our results and technology will be used
to investigate other fields of human CNS research (e.g. motor disorders, spinal cord injury, degenerative
conditions, etc). Additionally, we will have advanced development of objective biomarkers of pain. Future
directions of this research will apply these CNS biomarkers for neuroprognosis and neuroprediction to help
reduce the public health crisis of pain.

## Key facts

- **NIH application ID:** 10000184
- **Project number:** 5R01NS109450-03
- **Recipient organization:** STANFORD UNIVERSITY
- **Principal Investigator:** Gary H Glover
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $590,576
- **Award type:** 5
- **Project period:** 2018-09-30 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10000184

## Citation

> US National Institutes of Health, RePORTER application 10000184, Characterization of central pain mechanisms using simultaneous spinal cord-brain functional imaging (5R01NS109450-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10000184. Licensed CC0.

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